Merge Healthcare's Gilbert Gagne

Count imaging software vendor Merge Healthcare among those offering a mobile option for remote viewing of medical images. But rather than assume everybody wants an app for Apple or Android devices, the vendor is relying on the Web and the cloud to deliver high-quality images and access to radiology reports on mobile devices.

With the Merge iConnect Access system, users can just go to a URL on the iPad or other tablet, without having to download any special apps, to access images and related reports away from their imaging workstations. Yet, physicians still can take advantage of the iPad's advanced touch-screen capabilities for image manipulation.

Sliding one finger across the iPad screen changes the contrast and grayscale of a radiological image, Merge's team leader for enterprise solutions, Gilbert Gagné said during a demonstration of Merge iConnect Access at the company's new Chicago headquarters. (Following an accounting scandal and a reorganization, Merge brought in new management, relocated its home office from Milwaukee in 2010 and adopted orange as its color.)

Using two fingers pans the image. Zoom in and out with the pinch motion or double tap to see a larger version of the image in full screen mode. Buttons on the screen allow for additional image manipulation.

From the main screen, select a patient and up comes a study list. A patient history fly-out menu on the edge of the patient screen allows viewers to bring up as many as three studies simultaneously for side-by-side comparison. "I have full access to two studies," Gagné explained while demonstrating this feature with a pair of image sets.

Apple's iPad and iPhone cannot run Flash animations, and the browser-based system does not require Active-X or Java. "It's all done through what we call server-side rendering. Basically, everything takes place on the server, and then we render either a JPEG or a PNG file in either lossy or lossless, depending on the user preference, back out to the user," Gagné said.

"The other benefit with this is that it works really well in low-bandwidth situations. Since we're not transferring DICOM across the Internet, we are really working with small image files."

Like other companies with mobile imaging readers, Merge is targeting this technology toward physicians who refer patients to specialists for diagnosis and treatment. "It makes it really easy to get images from, say, the imaging center to the referring physician or from the hospital back out to the referring physician, again, without the need to download any software whatsoever," according to Gagné.

Mostly this is used for reference. Merge confirmed that while iConnect has FDA 510(k) clearance for diagnostic image viewing on certain monitors, it is not FDA cleared for diagnostic use on mobile devices.

"A radiologist may use this if he's not at his office or at home, if he's out to dinner, on the golf course, whatever it may be, and may need to see an image," Gagné said. "It's very easy to either pop open his iPad, his iPhone, or if he's at a friend's house for dinner and gets a phone call, because there's nothing to install, nothing to download, he can use that computer."

iConnect Access is part of the iConnect suite, a series of products and services for image sharing and workflow automation that includes a kiosk that automates patient check-in and payment.

For those who prefer an app, Merge does offer eFilm Mobile for the iPad, iPhone or iPod Touch. This app gives users of Merge eFilm Workstation software mobile access to work lists and studies, and can be used for image viewing.